Anyway, the big change is that I'm eating more mindfully, reviewing my data (because it's actually logged somewhere), and not allowing the fact that I have a new baby to derail my efforts at self-care.

Speaking of which, roly poly Dibbs is a whopping 18 lbs 6.5 oz at only 3.5 months old. o_O The boy is massive.

So at least we know my calorie reduction isn't affecting the smorgasbord that is the Dibbs lunch truck.

Sunday, May 20, 2012

Today's prompt: Diabetes Hero. Let’s end our week on a high note and blog about our “Diabetes Hero”. It can be anyone you’d like to recognize or admire, someone you know personally or not, someone with diabetes or maybe a Type 3. It might be a fabulous endo or CDE. It could be a d-celebrity or role-model. It could be another DOC member. It’s up to you – who is your Diabetes Hero??

For every mother or father who blames themselves unfairly because of their child's diagnosis...

For every mother or father who hides the tears from their child while they secretly worry about their lifespan, that summer camp, the school field trip...

For every mother or father weighing a donut, making 'special' treats for the party, asking the waiter to be sure that soda was diet...

For every mother or father who has to poke their baby with a needle, change their pump while they cry and beg for a reprieve, force feed a juice box at 3am...

Saturday, May 19, 2012

Today's prompt: Saturday Snapshots. Back for the third year, let’s show everyone what life with diabetes looks like! With a nod to the Diabetes 365 project, let’s grab our cameras again and share some more d-related pictures. Post as many or as few as you’d like. Feel free to blog your thoughts on or explanations of your pictures, or leave out the written words and let the pictures speak for themselves.

Today was a lovely day - spent with my family, spent with my friends at a little boy's birthday party, spent with my (adored) former students at a wedding...

But from a diabetes standpoint, it sucked.

Hell, from a d-standpoint, a lot of days suck.

Late to the birthday party - because pod fell off. New pod.

Lots of delicious party food, including random pieces of half-eaten cookie that Sweetie shoved into my mouth. How do you bolus for that?

Rush home for their nap. Rush to wedding. Rush home for Hubster and the littles. We all rush to wedding reception.

Lots of appetizers, including the handfuls of chocolate pieces that Sweetie shoved into my mouth. I didn't bolus for that.

But I chased my daughter around the dance floor for a good half hour - which I count as moderate to heavy exercise.

But by the time I got home, I just had this feeling. This feeling like there was no insulin in my body. I don't know how else to describe it. It feels like a high, it feels like ketones, it feels like dehydration...but I can just tell that there was no insulin in my body.

Friday, May 18, 2012

Today's prompt: What They Should Know. Today let’s borrow a topic from a #dsma chat held last September. The tweet asked “What is one thing you would tell someone that doesn’t have diabetes about living with diabetes?” Let’s do a little advocating and post what we wish people knew about diabetes. Have more than one thing you wish people knew? Go ahead and tell us everything.

My friend Susan has taught me a lot over the years and one of my favorite quotes from her is this:

"Wow. What is that like for you?"

It's what she asks me when we talk about my diabetes. It's what I've learned to ask her in regard to her anxiety and depression.

And now it has become what I ask the newly diagnosed. It's what I ask a frazzled parent of a type 1. It's even what I asked the man who got me a can of coke (for a low blood sugar) in Key West when he told me that his Golden Retriever had diabetes.

We all think we know so much. We especially think we can judge others because we know so much.

I know what it's like to be ME with diabetes, but I don't know what it's like to have been my friends or relatives.

Yet we are so quick to judge our relatives who "ate their way to diabetes." We are so quick to assume that Aunt Sue lost her feet because she didn't try hard enough. We are so quick to assume that we know better.

Every time I see a really hard-hitting anti-smoking commercial, I nod in agreement and say "There's a good one."

My husband, an ex-smoker, always says, "It won't work."

"Why not?" I asked one day. "Why won't knowing how harmful it is make someone want to quit?"

"You know you should exercise, right? You know it will make you healthier, stronger, make you live longer? But you don't do it, do you? Why not?"

"Because I don't want to."

"Exactly," he said.

Probably 99% of us at one time or another believe that people cause their own diabetes (type 2 especially). That they just don't listen to their doctors or make the changes they have to make.

First of all, that's a misconception about type 2, fueled by media hype and undereducated family doctors.

Second of all, give Granny a break. Making changes is crazy hard.

At best, major lifestyle changes may hold her diabetes diagnosis at bay for a couple of years. Maybe it will keep her off meds. Maybe it will add years to her life.

But she is tired. She has eaten a certain way or led a certain kind of life for longer than you have. She doesn't want to have to go through this. Making sweeping overhauls is hard and it's no magic bullet. There's no guarantee that she won't develop type 2 eventually. Lifestyle is only a part of it. Be supportive in her efforts. They are difficult and they are just part of the battle.

And if it's type 1 diabetes that your loved one is poorly controlling, a little support goes a lot further than a little derision. Who made you the diabetes police? You don't know what it's like for them, weighing, measuring, calculating, spiking, plummeting, shaking, raging...24/7.

Thursday, May 17, 2012

Today's Prompt: Fantasy Diabetes Device. Today let’s tackle an idea inspired by Bennet of Your Diabetes May Vary. Tell us what your Fantasy Diabetes Device would be? Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc etc etc. The sky is the limit – what would you love to see?

No sooner are you diagnosed than you start imagining a device that could make all of this easier.

Case in point: Melissa, age 11. Spring of 1991.

In fifth grade, my science teacher gave us the opportunity to participate in the Invent America contest, an educational contest designed to spark creativity among kids grades K-8. It was my first school year with diabetes and I knew instantly what my fantasy invention was.

The Sugar Sensor

I envisioned a pocket-sized (I was a visionary) blood glucose monitor that would read your BG level through a sensor pad.

No more pokes. And it took just seconds.

Here was my description:

"What is the need or problem solved? Diabetics can test their blood glucose level without the pain or bloody mess of pricking their finger. It can fit in your pocket or purse.

How does it work? Wipe the sensor pad with the special chemical solution. You press the O (on/off) button. You then press the T (time) button and the machine will have a 5-second warm-up time and then a beep will sound to indicate the machine is ready. You then place your index and middle fingers together gently on the sensor pad. While the machine counts off 10 more seconds, special sensors in the sensor (---> on back)...pad take a blood glucose, or blood sugar, reading through the oils on the surface of your skin. You then press the O button.

How is it made? It's made of high impact resistant plastic, a built-in timer, electronic sensors, and a J battery (believe me, there is one)"

That last bit cracks me up. J batteries. Oh my goodness. The meter I was using at the time took these monsters. They were impossible to find. I can't tell you how many drugstore and supermarket clerks my mother puzzled with descriptions of this elusive battery. There was one supermarket with a photo department in the next town over and there were usually 2 or 3 of them hanging on the shelf.

And now we can use our iPhones to check our blood sugar. My, how far we've come.

Still, when I see those misleading commercials (aimed at Type 2s, usually) that promise "pain-free" testing, I have to ask, when is that part coming? Will we ever ever measure anything in human blood without a needle involved?

Perhaps my "skin oils" sensor didn't make any sense, but it showed that, as Pollyanna as I seemed about my diabetes throughout those days, the stress of all the poking was in the back of my little mind.

I love having a CGMS (continuous glucose monitoring system) - even when it isn't perfectly accurate or reliable. But it hurts like a beeAHTCH to insert those sensors. With a needle.

I love having the ability to infuse insulin directly into my skin with a catheter I can barely feel, but I have to poke a sizeable hole in my body to make it happen every three days. With a needle. And I have my FOURTH site infection in a year right now. Luckily, I don't think this one is infected with MRSA like the first two were.

One of my only true FREAK-THE-F-OUTS where diabetes is concerned is the very real threat that a long-time veteran of the disease faces.

What am I supposed to do when I run out of real estate? What happens when it's all scar tissue? When it's all calloused? When I'm constantly at risk for staph from open wounds infusing liquid into my subcutaneous tissue? What happens when the drugs to fight the staph stop working?

What will I do when poking myself puts me as much at risk as NOT poking myself?

As I'm just about to hit "Publish" on this post, Sweetie, for the first time ever, is pointing to the pod on my arm and saying "A ouch. A ouch." I said, "No, Sweetie, a pod. PODuh." She looked at me and confirmed: "A ouch." Yes, baby. A ouch.

Wednesday, May 16, 2012

Today's prompt: One Thing to Improve. Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at. Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

If "needs improvement" items were monkeys, I'd have a barrel full.

For the last 6 years or so, managing my diabetes has been the first and last thing I think about everyday. That's a change from the 'chasing my tail' method of my younger days.

And it has shown in my great A1cs, improved standard deviation in my blood sugar, and the whole baby thing.

But the thing about diabetes is that it's never good enough.

I test 6-10 times per day - awesome, but, like most veterans, I don't change my lancet. Ever. And when I say that to people without diabetes (as I did today), you can hear a pin drop. Ew, they think. Eh, I reply. I'm still working through the 2nd or 3rd drum on my multiclix I've had since before my wedding. There is a box of lancets in my supply cart from 2001. But that's not an area where I plan to expend any energy.

There are 3 big ones where I'm going to admit to failure though:

Carb counting
Managing insulin during exercise
Analyzing trends

I eat pretty healthily - homemade, organics, whole grains, lean proteins, almost no sat fat (except for occasional sweets), but I know I SWAG my carb counts terribly. You couldn't even call it SWAGing. It's more like RWAGing ('random wild ass guessing') because the 'scientific' part is all hullabaloo for me.

I am often so so wrong. I'm trying to be better, but I'm annoyed that cooking from scratch - which makes my meals healthier - makes carb counting that much harder. No one slaps a nutritional label on my crockpot for me and tells me how to SWAG my minestrone. Is it 30g? 50g? 65g a bowl? How much is a bowl? 3/4 cup? 1 cup? What if I use lean beef and wheat macaroni? KILL ALL THE THINGS!!!!!!!

*breathes* Okay, what was I saying?

I'm also awful at managing exercise. I don't mean the getting out there and doing it - everyone is awful at that. I mean balancing the trifecta of insulin/food/activity. If you think I'm bad at the Food-to-Insulin See-Saw, you should see me sliding around on the Triangle of Terror.

Last night, we decided as we sat down to dinner (30g rice, $;@?g for the avocado tomato corn salsa on my grilled chicken) that we would indeed do our 2mile walk to the park and back with the kids. Okay. Crap. Okay. Here goes. I can do this.

I was 77 mg/dL before dinner, so I took no bolus insulin for my plate. As we start to head out the door, I'm 93. So far so good. Putting shoes on didn't screw me up then. I reduce my basal insulin by 50% for 90minutes. I grab every edible thing in the pantry and throw it in the basket of the stroller and I suck down a juice box (15g). Miraculously, I stay flat at 90 for the first mile (22minutes). We spent 12min at the park. By the time we are home, I'm at 80 on the CGMS. Best I've ever done. Test blood sugar. 70s. Still functioning on reduced basal, but expecting to continue dropping. So eat 30g. Wait patiently...still dropping...Decide to bake 4 dozen sugar cookies for party today. Handling the sugar on my skin (perhaps sampling some too) raises my blood sugar to 300. Oh f*ckitalltoblazes. I just can't win. I will be my own undoing.

Which brings me to pattern management. I can't make accurate changes to my dosages on my own. Lots of people can. Maybe I don't have the same eye for the details. If I do log my numbers, meals, and activity, I can't make sense of it. I literally hand over my pump and CGMS to my CDE (aka the Evil Genius) and she figures it all out and hands it back to me.

To be honest though, I know I could. I feel like it's a failure of spirit. My numbers are frustrating to me because I feel them. To her and you and my endo, they are just data.

I can't see the forest because I keep smacking my face into tree trunks. She can step back and say, "Look at the lovely Spruces."

I need that. I need to be able to hand it all to somebody and just say, "Here. Fix it."

But she won't always be there. I would like to learn how to fix my basals and ratios myself. I have a brain. I have a book. I have a calculator. I just don't have the will.

Tuesday, May 15, 2012

Today's prompt: One Great Thing. Living with diabetes sure does take a lot of work, and it’s easy to be hard on ourselves if we aren’t “perfect”. But today it’s time to give ourselves some much deserved credit. Tell us about just one diabetes thing you do spectacularly! Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes. Nothing is too big or too small to celebrate doing well!

Today I'm asked to describe an aspect of diabetes that I'm really great at.

And I keep coming up short.

There was a time...we will call it the nineties...where I was great at logging my blood sugars. Never missed writing one down - from diagnosis at age 10 through at least age 18. I carried one of those kitschy four-color pens and diligently logged breakfast, lunch, dinner, and snack each in its own bright color, even notating my dosage and where I gave my injection. (In those days, I also changed my lancet four times a day. Haha.)

But all of the logged data in the world (aka 'compliance') didn't have any effect on my A1cs. I floated between 11-16% for my first three years with D. By age 16, I was pretty consistently hanging in the 9-10% range where I would stay until age 24.

So I suppose I was also good at surviving.

I hear dParents talk these days about their kids' A1cs creeping into the 8s and 9s as though their child is teetering on the brink of oblivion.

I don't know whose perspective is closer to the truth, to be honest.

I just know I'm pretty awesomely healthy considering those stats. Considering I stopped logging and, for too many years, stopped believing my efforts had any measurable outcome on my blood sugar management.

But I survived to build a career. I survived to build a marriage. And with the combined encouragement of a supportive spouse, the DOC, and the right mix of doctors, I learned to manage my diabetes really well and so I survived to build a family.

I wish I could tell you how, but this disease is spectacularly unfair. Compliance bought me no victories; indifference bought me no tragedies.

Monday, May 14, 2012

Before I became a mom, I had no idea there was a cultural "war" among mommies of various parenting styles. My best friend went back to work and her son was a happy formula-fed baby. I knew I wanted to put my career on hold to stay home while my kids were young and that I would breastfeed my kids. Who knew we were supposed to be at war over these choices?

Attachment Parenting as a phrase/philosophy/mindset may seem relatively new, but it's how I was raised, honestly. I shared my parents' bed until I was nine. I was breastfed for a year. I can count the times on one hand that my mom left my side in those very early days. It's no surprise that it seems like an intuitive way for me to parent.

AP has been in the media a lot recently - with Mayim Bialik (tv's Blossom) putting out a popular book about how she parents as an attachment parenter, to French feminist Elisabeth Badinter's book The Conflict that thumbs its nose at some American women's preference for AP, to the most talked about Time magazine cover in years.

In my opinion, it has painted my parenting practices as some sort of 'extreme' parenting. 'Martyr mothering.' Selfish mommies who just can't let go. Downtrodden women who are slaves to their offspring. Many of my friends, relatives, and social media acquaintances occasionally make judgmental remarks about extended breastfeeding, co-sleeping (specifically bedsharing), and babywearing - three of the most popular practices among AP adherents.

I know the whole point is to make us all come to the defense about our parenting choices. It's sport, really - pitting mommy against mommy. There are real issues to contend with. Parents who neglect their children, children without parents, (far right) single women (like one I met the other day) who won't adopt a wanted child because there isn't a man in the picture, (far left) earth mamas who are foregoing critical immunizations out of fear of some autism conspiracy theory. Whether my kid gets boob or bottle, goes to preschool or goes to playgroup...none of these idiosyncrasies should matter.

But I also know that there are some weird misconceptions surrounding the practice of attachment parenting. And I'm of the die hard opinion that it's the right path for me. So I'd like to put a few weird speculations to rest. And it's my blog, so I can do that.

Attachment parenting, developed by a pediatrician and his nurse wife who themselves parented 8 kids, is a philosophy that believes that children who develop secure attachments with their parents in their formative early years, whose needs are met quickly and sensitively, will develop into secure, empathetic, independent adults.

There are 8 principles. The 8th of these is to make sure you are striking a healthy balance in personal and family life - which means that if you feel like a martyr who has to give up their own sense of self to practice AP, it's not the right parenting style for you and/or you're not finding that balance.

AP practitioners like myself believe that "cry-it-out" and corporal punishment (hitting) are not sensitive ways to respond to a child's needs.

We believe in holding babies and in skin-to-skin contact, and many of us practice babywearing as a means of providing that contact that a baby needs and enjoys while still being able to enjoy handsfree parenting.

It is not anti-stroller in the sense that there is anything wrong with a stroller (I own four different strollers myself), but it discourages a culture of "container babies" where an infant is left being held by some kind of mechanical soother or 'container' for the majority of the day.

AP is certainly pro-breastfeeding for both its nutrative and nurturing benefits, but it encourages those who do use bottle feeding to try to replicate the closeness of the breastfeeding relationship. No bottle propping, lots of cuddling, eye contact, etc. It's not anti-bottle.

We get a lot of blowback over co-sleeping (which people think exclusively refers to bedsharing), but AP explains co-sleeping as an infant room-sharing with the mother. Many people do that for the first few weeks and simply don't call it that. But AP believes that infants need nighttime parenting as well and discourages the practice of leaving young babies by themselves.

I wanted to stay home while my babies are young. I wanted to breastfeed them - because it's healthy, biologically normal, and beautiful. I love wearing a baby - the way they just melt into you with their head against your heart, wrapped safely against your body, while you still have your hands free.

And from the moment they were born, I wanted them to sleep happily and safely and soundly - which they do when they are snuggled against me - either in my wrap or in my bed. I did not plan to bedshare with Sweetie. We bought a beautiful crib when I was pregnant - a crib that sits in a lovely nursery a world away on our second floor. But when she slept between us, we all three slept better. And by the time Dibbs was 6 weeks old, it was clear that he would sleep through the night only if he was snuggled in the crook of my arm where he could nurse at will throughout the night.

People hear that I bedshare and usually say, "Oh, I could never. I need my sleep." Well, for this family, it's how we get our sleep.

What AP is not is a rigid belief system with rules to follow. It does not privilege discipline over understanding. It does not say you must do this or must do that. It does not take a stance about vaccines or circumcision or television or diapering.

That being said, since most AP practitioners are stay-at-home moms (or dads), many of us are cloth diapering or making our own baby food (which I do) or enjoying (or not enjoying) some of the choices that are not an easy option for full-time working moms. Again, there's nothing in the 8 AP principles that say you have to be a barefoot earth mama. But there's also nothing that says you can't.

And, for the record, breastfeeding 3-5 year olds is perfectly anthropologically normal. Posing defiantly with your preschooler on your boob on the cover of Time? Not so much.

Today marks the first day of the third annual Diabetes Blog Week, hosted by Karen at Bittersweet Diabetes. (Click for the Find A Friend - Monday 5/14 Link List.)

Today's prompt: Find a Friend. It seems the most popular thing about Diabetes Blog Week is that it helps us find blogs we weren’t reading yet and connect with some new blog friends. With that in mind, let’s kick off Diabetes Blog Week by making some new connections. Think about the d-blogs you read that you think we may not know about and introduce us to one that you love!! Let’s all find a new friend today! (Special thanks to Gina, everybody’s Diabetes BFF, for helping me title this post!)

If you read blogs by people with diabetes, then you probably already know the who's who of the DOC. These guys and gals set the tone years ago for authenticity and advocacy in diabetes writing. I am a johnny-come-lately to this bunch and am happy just to join in the fray.

That being said, it would be impossible to follow every post by everyone who is worth reading. I've met at least 50 of the DOC bloggers and I'd read all of them if I didn't need to, you know, function. Most of us try to catch the posts we see and that's the best we can do.

But I can think of at least two bloggers I never miss if they broadcast that there is a new post - Sarah Mart at smartDpants and Lee Ann Thill of The Butter Compartment.

Maybe it's because they seem like women I'd love to hang out with but haven't had the pleasure.

Maybe it's because they have struggled with D for at least a decade longer than I have and I consider them warrior princesses who know how to rock it old school.

But more likely it's because they are both smart mouthed, intelligent storytellers and I see a bit of myself in them.

Thursday, May 10, 2012

Weight Watchers is very D-friendly. While we as people with diabetes very frequently get turned away from programs like Jenny Craig and Nutrasystem, Weight Watchers will turn a blind eye. You'd think weight loss programs would cater to people with D. You hear about NutrasystemD specifically for people with D. Yeah, unless you have Type 1, use insulin, or use an insulin pump. Then they 'review' your health history, freak out, and want nothing to do with you.

So I've always respected Weight Watchers.

I adapt it to meet my needs though, working in incentives to handle my diabetes correctly in the process.

For instance, low blood sugars.

In the beginning, I remember wanting to exempt myself from the foods I ate to treat a low, thinking it was unfair to ask me to give up 'points' for food I wasn't eating by choice. But that's part of the problem. I was eating whatever I wanted to treat the low. I might have 2-3 lows a day and treat each with 2-4pts.

So I decided early on that, if I treat the low with glucose tabs, I may exempt it. If I treat with food, I have to count it. There have been two days this week where I ate food for the lows and watched a third of my daily points slip away on banana peels and crackers. And one day where I used glucose tablets and a juice box and lost a mere two points.

See my point?

Hubster argues that I'm still taking in calories, so I should count the glucose tabs, too. But it'd be too easy for me to turn my nose up at the tabs if they cost me my precious points.

This way, there is an incentive for me to treat with the tabs - which is the faster, smarter, grosser way to handle a low from the diabetes standpoint.

From a weight loss standpoint, it is highly doubtful that 60cal of fat free chalky tablets will be my downfall.

And from a motivation standpoint, I won't give up the program from resentment or burnout because I can insure that my points will be used for meals and snacks (like regular people).

That being said, it's hard. I had three lows Tuesday - a 49 upon waking, a 50 around 3:30p, and an I-didn't-check-because-I'm-busy-cooking-dinner around 7p. They cost me a juice box (2) and coffee (1), a banana (2) and 2 rice krispie treats (4), and another banana (2). 11 points. Ouch.

Wednesday was worse. I used at least 15 points to treat low blood sugars. And only reached for glucose once. =\

Today, I'll do better. I'll really try to do better. And maybe I'll start dialing back some of my insulin, too. Nobody should be low as often as I am. Sigh.

Disclaimer: I'm neither a medical professional nor a nutritional expert. Please pursue nutritional programs and make adjustments with the help and advice of your own medical team.

Monday, May 7, 2012

I go back and forth with my relationship with cloth. It's a lot easier than people think it is, but, admittedly, it's not as easy as disposable diapering. When we go on vacation, I take disposables. They're convenient and require no thought or preparation.

But the thought of how much waste a single baby's diapers contribute to a landfill is a staggering one for me. And we spent a lot less money on high-end cloth than if we had gone with all disposable. That sold Hubster on it. It paid for itself in about 5-6 months - and now we are using them on a second kid.

I've been cloth diapering since July of 2010, so nearly two years. I've learned a lot about what I like and what I love. And a lot of friends ask me a lot of questions about it.

So I've decided to make a few short videos to show how I make it work for our family.

1) eat more reasonable portion sizes of the things I already eat
2) lose a little of the baby weight
3) reduce my A1c by necessarily reducing my total intake (and by extension, carbs) at meals
4) make a renewed commitment to my blood sugar control

You have no idea how quickly and easily that can slip away from you. If I look at my blood sugars from this weekend alone (see screenshot), my A1c could be climbing a whole 1% higher than it was a month ago. That's HUGE. And it means I've got to get my butt in gear.

Hubster has never told me I looked ridiculous before.Then he saw the outfit I chose to go walking in tonight.What's wrong with 80s shortie shorts and navy socks?

When I get my A1c checked again in August, 3 months from now, I would like to be closer to the following:

A1c: 6.5%
Weight: 173 lbs.
Pants size: 14

I'll update you on my efforts with specific attention to how my food choices affect my insulin and blood sugars.

As you can see in the picture, I am also playing around with the iBGStar Diabetes Manager App. I am on the fence about whether to purchase and begin using the accompanying meter (which docks onto the iPhone), but so far I think their interface is deliciously slick.

Seeing my high pre- and post- meal numbers in the logbook screen was the kick in the pants that I needed. It's time to pay attention. Again.

About Me

My name is Melissa Lee and I serve as Interim Executive Director of Diabetes Hands Foundation. I write for the online diabetes magazine A Sweet Life.org where I serve as Tech Editor as well as for my personal blog, Sweetly Voiced. I'm a patient advocate and technology enthusiast, married to a Nightscout core developer, and mom to 2 little kids who stole my heart and my sanity.